title: Risk factors and incidence of thromboembolic events (TEEs) in older men and women with breast cancer.
abstract: BACKGROUND
  The purpose of this study is to evaluate the risk factors and the prevalence of thromboembolic events (TEEs) in breast cancer patients.
  
  
  METHODS
  This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare database. Breast cancer patients diagnosed from 1992 to 2005 ≥66 years old were identified. International Classification of Diseases, Ninth Revision, and Healthcare Common Procedure Coding System codes were used to identify TEEs within 1 year of the breast cancer diagnosis. Analyses were conducted using descriptive statistics and logistic regression.
  
  
  RESULTS
  A total of 89 841 patients were included, of them 2658 (2.96%) developed a TEE. In the multivariable analysis, males had higher risk of a TEE than women [odd ratio (OR) = 1.57; confidence interval (CI) 1.10-2.25] and blacks had higher risk than whites (OR = 1.20; CI 1.04-1.40). Compared with stage I patients, patients with stage II, III and IV had 22%, 39% and 98% increase, respectively, in risk. Placement of central catheters (OR = 2.71; CI 2.43-3.02), chemotherapy treatment (OR = 1.66; CI 1.48-1.86) or treatment with erythropoiesis-stimulating agents (ESAs) (OR = 1.33; CI 1.33-1.52) increase the risk. Other significant predictors included comorbidities, age, receptor status, marital status and year of diagnosis. Similar estimates were seen for pulmonary embolism, deep vein thromboembolism and other TEEs.
  
  
  CONCLUSIONS
  In total, 2.96% of patients in this cohort developed a TEE within 1 year from breast cancer diagnosis. Stage, gender, race, use of chemotherapy and ESAs, comorbidities, receptor status and catheter placement were associated with the development of TEEs.
authors.affiliation: Division of Cancer Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Chavez-MacGregor
authors.affiliation: Department of Breast Medical Oncology.
authors.forename: H
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Section of Benign Hematology.
authors.forename: M
authors.initials: M
authors.lastname: Kroll
authors.affiliation: Department of Breast Medical Oncology.
authors.forename: S
authors.initials: S
authors.lastname: Fang
authors.affiliation: Department of Breast Medical Oncology.
authors.forename: N
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Breast Medical Oncology.
authors.forename: G N
authors.initials: GN
authors.lastname: Hortobagyi
authors.affiliation: Division of Radiation Oncology.
authors.forename: T A
authors.initials: TA
authors.lastname: Buchholz
authors.affiliation: Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, USA.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Shih
authors.affiliation: Department of Breast Medical Oncology. Electronic address: sgiordan@mdanderson.org.
authors.forename: S H
authors.initials: SH
authors.lastname: Giordano
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D018567:Breast Neoplasms, Male / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D015995:Prevalence; D012307:Risk Factors; D018426:SEER Program; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology